Claim total
$1,125.37
base $93.83 · payer covered $715.45
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-06-06
- Stop
- 2009-06-06
The parties
- Patient
- patient Alyson Trula Bernier
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
25c888b3-d617-8ac8-339f-94c0157abca8